what are some signs and symptoms a patient on warfarin should report to their doctor

by Ferne Marquardt 10 min read

A Patient's Guide to Taking Warfarin - American Heart …

18 hours ago  · This complication occurs within a few days of starting warfarin treatment. Seek immediate medical care if you notice sores, changes in skin color or temperature, or severe pain on your skin. Talk to your health care provider about these less serious side effects. Bleeding from the gums after toothbrushing. >> Go To The Portal


Excessive bleeding can occur in any area of the body, and patients taking warfarin should report any falls or accidents, as well as signs or symptoms of bleeding or unusual bruising, to their healthcare provider. Signs of unusual bleeding include bleeding from the gums, blood in the urine, bloody or dark stool, a nosebleed, or vomiting blood.

Excessive bleeding, or hemorrhage, can occur from any area of the body even if the warfarin is having the desired (rather than an excessive) effect, and people on warfarin should report any falls or accidents, as well as signs or symptoms of bleeding or unusual bruising.Jun 16, 2021

Full Answer

What to know before taking warfarin?

A Patient's Guide to Taking Warfarin 1 The formation of a clot in the body is a complex process... 2 Monitoring and Dosing Tips. The goal of warfarin therapy is to decrease the clotting tendency... 3 Difference Between Brand-Name and Generic Medications. 4 Warfarin must be taken exactly as prescribed. 5 Side Effects. The major complications...

What are the symptoms of excessive bleeding from warfarin?

Excessive bleeding can occur in any area of the body, and patients taking warfarin should report any falls or accidents, as well as signs or symptoms of bleeding or unusual bruising, to their healthcare provider. Signs of unusual bleeding include: bleeding from the gums, blood in the urine,

What are the risks of taking warfarin?

The same action of warfarin that prevents blood clotting can result in bleeding. Warfarin treatment requires careful monitoring. Certain foods, medications, diet changes and illnesses can interfere with warfarin and increase your risk of bleeding.

How do I write an emergency alert for warfarin?

The alert should include a list of major medical conditions and the reason warfarin is needed, as well as the name and phone number of an emergency contact. Your healthcare provider is the best source of information for questions and concerns related to your medical problem.

What are some signs and symptoms a patient on warfarin therapy should immediately report to the doctor?

If you experience any of the following symptoms, call your doctor immediately: pain, swelling, or discomfort, bleeding from a cut that does not stop in the usual amount of time, nosebleeds or bleeding from your gums, coughing up or vomiting blood or material that looks like coffee grounds, unusual bleeding or bruising, ...

What is the most serious side effect of warfarin?

The main side effect of warfarin is bleeding. If you're taking warfarin, you may have trouble stopping the bleeding from a cut on the hand or a nosebleed. More-serious bleeding may be inside the body (internal).

What are the symptoms of too much warfarin?

You have a severe headache or dizziness. You have heavy bleeding that does not stop. You have severe stomach pain or you vomit blood. Your urine is pink, red, or dark brown.

What should I monitor for warfarin?

Monitoring Warfarin If the dose of warfarin is too high, the patient may be at risk of serious bleeding. It can be monitored by drawing blood from a vein and sending the blood to an accredited laboratory to test, or it can be monitored by testing blood from a fingerstick with an INR test meter outside of a laboratory.

What are the symptoms of internal bleeding from blood thinners?

Signs of excessive bleeding can include:passing blood in your urine.passing blood when you poo or having black poo.severe bruising.prolonged nosebleeds (lasting longer than 10 minutes)vomiting blood or coughing up blood.sudden severe back pain.difficulty breathing or chest pain.More items...

What are the symptoms of high INR levels?

Signs of bleeding or a high INR are: Gums bleed when you brush your teeth. Coughing up blood. Vomit that looks like coffee grounds. Bruising in unusual areas or for unknown reasons.

What are the symptoms of low INR?

These symptoms may include swelling, redness, tenderness and/or warmth in one leg or one area of one leg and generalized leg pain, difficulty breathing, chest pain, shortness of breath, breathing quickly, dizziness, Page 2 increased heart rate or low blood pressure, partial or total paralysis, inability to speak or ...

What are the most common side effects of blood thinners?

Blood thinners may cause side effects in some people. Excessive bleeding is the most common reaction....Possible side effects of blood thinnersheavy periods.bloody or discolored urine or feces.nosebleeds.bleeding gums.prolonged bleeding from a cut.

Does warfarin cause high blood pressure?

The results demonstrate that warfarin therapy at conventional doses does not increase systolic blood pressure or pulse pressure in patients with diabetes and hypertension.

What should the nurse teach a client who is taking warfarin?

Caution patient to avoid IM injections and activities leading to injury. Instruct patient to use a soft toothbrush, not to floss, and to shave with an electric razor during warfarin therapy. Advise patient that venipunctures and injection sites require application of pressure to prevent bleeding or hematoma formation.

What can happen if INR is too high?

If the INR is too high, you are at increased risk of bleeding. But the INR will usually come back down into the right range when you skip a couple doses of your medication. If you develop bleeding while your INR is too high, it can be life-threatening.

What are the effects of INR?

Multiple factors such as vitamin K consumption, drug interactions, herbs interactions, disease states, and alcohol intake affect international normalized ratio (INR) values and thus warfarin dosing. These variables have been described in general and for all patients in the literature.

When Is Warfarin prescribed?

You might be given warfarin if you have: 1. A blood clot in or near your heart that could trigger stroke, heart attack or organ damage 2. A blood c...

What Warfarin Side Effects Should You Watch for?

When you take warfarin, your blood won't clot as easily. If you accidentally cut yourself while taking warfarin, you may bleed heavily. However, th...

Warfarin Side Effects That Require Immediate Medical Attention

1. Severe bleeding, including heavier than normal menstrual bleeding 2. Red or brown urine 3. Black or bloody stool 4. Severe headache or stomach p...

Less-Serious Warfarin Side Effects to Tell Your Doctor About

1. Bleeding from the gums after you brush your teeth 2. Bleeding between menstrual periods 3. Diarrhea, vomiting or inability to eat for more than...

What Precautions Can You Take Against Warfarin Side Effects?

To reduce your chance of developing warfarin side effects: 1. Tell your doctor about any other medications or supplements you take. Many medication...

What Drugs and Supplements Can Interact With Warfarin?

Like any other medication, warfarin can interact with foods, other drugs, vitamins or herbal supplements. The interaction might lower the effective...

What Foods and Drinks Might Interact With Warfarin?

Foods and drinks that might interact with warfarin include: 1. Cranberries or cranberry juice 2. Alcohol 3. Foods that are high in vitamin K, such...

What Should You Do If You Forget A Dose?

Never take a double dose of warfarin. Doing so could greatly increase your risk of side effects.If you miss a dose, take it as soon as you remember...

What are the side effects of warfarin?

The main side effect of warfarin is bleeding. While the risk of major bleeding is low, you need to be aware of potential problems. For example, you might have trouble stopping the bleeding from a cut on your hand or a nosebleed. More-serious bleeding may occur inside the body (internal).

What drugs, supplements and foods interact with warfarin?

Like any other medication, warfarin can interact with certain foods, drugs, vitamins or herbal supplements. An interaction might lower the effectiveness of warfarin or increase your risk of bleeding.

What can you do to lower the risk of bleeding?

To reduce the risk of a bleeding event from warfarin treatment , follow these guidelines:

What should you do if you forget a dose?

If you miss a dose, take it as soon as you remember. If you don't remember until the next day, call your doctor for instructions. If your doctor isn't available, skip the missed dose and resume your normal dosing schedule. Never take a double dose.

Why do people take warfarin?

Some people who take warfarin are at a higher risk of bleeding because their genetics make them more sensitive to the medication. Your doctor may recommend a genetic test to determine the best dose for you. Medical conditions that increase the risk of bleeding include: Uncontrolled blood pressure. A history of stroke.

What foods are good for warfarin?

Foods rich in vitamin K are green vegetables, including lettuce, spinach and broccoli. If you are taking warfarin, the amount of vitamin K in your diet may affect how well the medicine works. If you take warfarin, it's important to have a consistent amount of vitamin K in your diet. Too little vitamin K can increase your risk of bleeding.

What to use to prevent bleeding?

Use safer hygiene and grooming products. A soft-bristle toothbrush, waxed dental floss and an electric razor for shaving can help prevent bleeding.

How Does Warfarin Work?

Warfarin decreases the body’s ability to form blood clots by blocking the formation of vitamin K–dependent clotting factors. Vitamin K is needed to make clotting factors and prevent bleeding. Therefore, by giving a medication that blocks the clotting factors, your body can stop harmful clots from forming and prevent clots from getting larger.

How does alcohol affect warfarin?

Alcohol - Alcohol intake can affect how the body metabolizes warfarin. Patients undergoing warfarin therapy should avoid drinking alcohol on a daily basis. Alcohol should be limited to no more than 1 to 2 servings of alcohol occasionally. This means an average of one to two drinks per day for men and one drink per day for women. (A drink is one 12 oz. beer, 4 oz. of wine, 1/5 oz. of 80-proof spirits, or 1 oz. of 100-proof spirits). The antiplatelet effect of alcohol increases the risk of major bleeding, even if the INR remains within the target range.

What is generic drug?

Generic drugs are supposed to have the same dosage, therapeutic effects, route of administration, side effects, and strength as the original drug. The U.S. Food and Drug Administration requires that all generic drugs be as safe and effective as brand-name drugs.

How does warfarin affect blood clotting?

The goal of warfarin therapy is to decrease the clotting tendency of blood, not to prevent clotting completely. Therefore, the effect of warfarin must be monitored carefully with blood testing. On the basis of the results of the blood test, your daily dose of warfarin will be adjusted to keep your clotting time within a target range. The blood test used to measure the time it takes for blood to clot is referred to as a prothrombin time test, or protime (PT). The PT is reported as the International Normalized Ratio (INR).

What is the purpose of warfarin?

Warfarin (brand names Coumadin and Jantoven) is a prescription medication used to prevent harmful blood clots from forming or growing larger. Beneficial blood clots prevent or stop bleeding, but harmful blood clots can cause a heart attack, stroke, deep vein thrombosis or pulmonary embolism. Because warfarin interferes with the formation of blood clots, it is called an anticoagulant (PDF). Many people refer to anticoagulants as *blood thinners; however, warfarin does not thin the blood but instead causes the blood to take longer to form a clot.

Do you have to stop taking warfarin?

It is important to tell all your healthcare providers that you are taking warfarin. If you are having surgery, dental work, or other medical procedures, you may need to stop taking warfarin .

Does warfarin cause bruising?

The major complications associated with warfarin are clotting due to underdosing or bleeding due to excessive anticoagulation. The most serious bleeding is gastrointestinal or intracerebral. Excessive bleeding can occur in any area of the body, and patients taking warfarin should report any falls or accidents, as well as signs or symptoms of bleeding or unusual bruising, to their healthcare provider.

What are signs of a blood clot?

You are taking warfarin to help protect you from having a blood clot or prevent you from getting another one. Call your health-care provider if you have:

How to tell if you are taking warfarin?

You are taking warfarin to help protect you from having a blood clot or prevent you from getting another one. Call your health-care provider if you have: 1 Painful and constant swelling or redness in your feet, lower legs, or arms 2 Bad headache 3 Blurred vision 4 Dizziness 5 Trouble breathing 6 Chest pain 7 Feelings of severe weakness 8 Numbness or tingling of hands, feet, or face 9 Not being able to move 10 Sudden confusion

What are the side effects of warfarin?

What are side effects of warfarin? Side effects from warfarin are not common, but can happen. The most common side effect is bleeding. To lower your chance of bleeding, your INR should be in the range set for you. If you have any of the side effects listed below, tell your health-care provider right away. You may need to change your dose.

How to tell if INR is high?

Signs of bleeding or a high INR: Bleeding from cuts that do not stop. Nosebleeds that do not stop. Gums bleed when you brush your teeth. Coughing up blood. Vomit (throw-up) that looks like coffee grounds. Bruising for unknown reasons. Heavy periods or unexpected bleeding from the vagina.

What does it mean when you have a dark brown poop?

Heavy periods or unexpected bleeding from the vagina. Bowel movements (poop) that looks black or have blood in them. Rust-colored or dark brown urine (pee) Bleeding in the eye. Getting a sudden headache, dizziness, or weakness.

What else should I do while I am taking warfarin?

Wear medical alert jewelry or carry a card that says you take warfarin. Ask where to get these items.

How do I safely take warfarin?

Go to all your follow-up appointments. Your healthcare provider will need to monitor you closely while you are taking warfarin. He may need to adjust your dose based on your INR results.

What is warfarin toxicity?

Warfarin toxicity happens when you have too much warfarin in your body. Certain changes to foods and medicines can also increase the effect of warfarin. Warfarin is a medicine that is used to prevent or treat the formation of blot clots. It works by making your blood clot more slowly. Warfarin toxicity can cause bleeding that can become life-threatening.

How to keep INR stable?

Talk to your healthcare provider before you start or stop any medicines. Eat the same amount of vitamin K daily to help keep your INR stable. Vitamin K is found in green leafy vegetables, broccoli, grapes, and other foods. Ask your healthcare provider for more information about vitamin K. Avoid alcohol.

What is the INR of blood?

The INR, or International Normalized Ratio, is a measure of how long it takes your blood to clot. Your risk of bleeding increase over time when your INR is too high. A sudden decrease of vitamin K in your diet can increase your risk of bleeding. Vitamin K changes how your blood clots.

Can you take warfarin if you miss a dose?

Take this medicine exactly as directed. Contact your healthcare provider if you miss a dose or you have any questions about how to take warfarin.

Can you take warfarin if you don't have an INR?

You take higher doses of warfarin than is recommended by your healthcare provider. Your risk of warfarin toxicity increases if you do not have your INR checked as recommended. Your healthcare provider adjusts your dose based on your INR.

How Does Warfarin Work?

Warfarin decreases the body’s ability to form blood clots by blocking the formation of vitamin K–dependent clotting factors. Vitamin K is needed to make clotting factors and prevent bleeding. Therefore, by giving a medication that blocks the clotting factors, your body can stop harmful clots from forming and prevent clots from getting larger.

What is the purpose of Warfarin?

Warfarin (brand names Coumadin and Jantoven) is a prescription medication used to prevent harmful blood clots from forming or growing larger. Beneficial blood clots prevent or stop bleeding, but harmful blood clots can cause a stroke, heart attack, deep vein thrombosis, or pulmonary embolism.

What is the purpose of taking Coumadin?

Warfarin (brand names Coumadin and Jantoven) is a prescription medication used to prevent harmful blood clots from forming or growing larger. Beneficial blood clots prevent or stop bleeding, but harmful blood clots can cause a stroke, heart attack, deep vein thrombosis, or pulmonary embolism.

Why is warfarin called an anticoagulant?

Because warfarin interferes with the formation of blood clots, it is called an anticoagulant. Many people refer to anticoagulants as “blood thinners”; however, warfarin does not thin the blood but instead causes the blood to take longer to form a clot.

What is the PT in blood work?

The blood test used to measure the time it takes for blood to clot is referred to as a prothrombin time test, or protime (PT). The PT is reported as the International Normalized Ratio (INR). The INR is a standardized way of expressing the PT value.

What is a medical alert tag?

If an accident occurs and the person is too ill to communicate, a medical alert tag will help responders provide appropriate care. The alert should include a list of major medical conditions and the reason warfarin is needed, as well as the name and phone number of an emergency contact.

What is the goal of color coded doses?

The goal is to allow the patient to identify the color-coded dose and prevent mix-ups or errors. Therefore, if the color or dose of the dispensed tablet appears different from the pill taken previously, the patient should immediately notify the dispensing pharmacist or healthcare provider.

Can warfarin cause problems?

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains some of the more common ones associated with warfarin - the most common are bleeding and bruising. You will find a full list in the manufacturer's information leaflet supplied with your medicine. Speak with your doctor or pharmacist if any of the following continue or become troublesome.

Why is warfarin used for a clot?

Warfarin is used to prevent unwanted clots from forming if you have a condition that puts you at risk of this happening, such as atrial fibrillation. It is also used to prevent any clots that may have already formed in the blood vessels of your legs, lungs or heart from becoming larger and causing problems.

How does changing diet affect INR?

A major change in diet may mean that you need closer monitoring and may need a change in warfarin dose .

How many strengths of Warfarin are there?

Warfarin tablets are available in different strengths. Your dose may be made up of more than one strength of tablet. Each strength of tablet is a different colour to help you tell the difference between them; 0.5 mg tablets are white, 1 mg tablets are brown, 3 mg tablets are blue and 5 mg tablets are pink. If you have been prescribed the oral ...

How does warfarin work?

Warfarin is an anticoagulant, which means that it increases the time it takes for your blood to clot. It works by reducing the effects of vitamin K , which is a vitamin your body uses in the process of blood-clotting. Warfarin is used to prevent unwanted clots from forming if you have a condition that puts you at risk of this happening, ...

What is yellow anticoagulant?

It will be prescribed if you have an unwanted clot in your blood, or if you are at risk of having an unwanted clot. You may be given a yellow anticoagulant treatment booklet; read this carefully and carry it with you at all times. You will need to have regular blood tests to measure how quickly your blood clots.

How long does it take to stop taking warfarin?

Continue to take warfarin tablets regularly until your doctor tells you to stop. A course of treatment typically lasts from six weeks to three months, although some people may be advised to continue taking warfarin for longer than this.

WHAT SHOULD BE EATEN?

There is no specific diet which needs to be followed if you are on WARFARIN [COUMADIN] but there are some foods which can make WARFARIN less effective.

Foods that are rich in Vitamin K include –

Fruits such as watermelon, pineapple, bananas, peaches, apple and strawberries.

Why is it important to have a PT/INR checked?

It is very important to have the PT/INR checked to monitor safety and adjust dosages. Doses of your medication can occasionally change.

Can you take aspirin with warfarin?

DO NOT use aspirin or other NSAIDs. Check labels of all OTC products carefully before use. Many cough and cold products contain aspirin and/or NSAIDs. DO NOT use other blood thinners, garlic, ginseng, ginkgo, vitamin E, or other herbals without talking to your doctor first. Over 60 herbal therapies have anti platelet effects or may interact with warfarin in other ways. DO NOT start any herbal therapy without talking to your prescriber or pharmacist.

How to remember to take medication?

Take medication at the same time each day to help you remember to take it.

Can you get pregnant with a birth control pill?

You should NOT become pregnant while taking this medicine. Use a birth control you can trust. If you get pregnant while taking this medicine, call your doctor right away. If you wish to become pregnant, discuss this with your doctor first. Tell your doctor if you are breast feeding.

Mechanism

Treatment

  • The goal of warfarin therapy is to decrease the clotting tendency of blood, not to prevent clotting completely. Therefore, the effect of warfarin must be monitored carefully with blood testing. On the basis of the results of the blood test, your daily dose of warfarin will be adjusted to keep your clotting time within a target range. The blood test used to measure the time it takes for blood to …
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Purpose

  • The INR is a standardized way of expressing the PT value. The INR ensures that PT results obtained by different laboratories can be compared. It is important to monitor the INR (at least once a month and sometimes as often as twice weekly) to make sure that the level of warfarin remains in the effective range. If the INR is too low, blood clots will not be prevented, but if the I…
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Administration

  • Unlike most medications that are administered as a fixed dose, warfarin dosing is adjusted according to the INR blood test results; therefore, the dose usually changes over time. Coumadin/ warfarin pills come in different colors, and each color corresponds to a different dose (see graphic below).
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Risks

  • The major complications associated with warfarin are clotting due to underdosing or bleeding due to excessive anticoagulation. The most serious bleeding is gastrointestinal or intracerebral. Excessive bleeding can occur in any area of the body, and patients taking warfarin should report …
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Diagnosis

  • If you experience the following signs of bleeding, you should call 9-1-1 or your healthcare provider immediately:
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Significance

  • Changes in daily living can affect the INR. It is important to know common dos and donts for warfarin therapy.
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Contraindications

  • Warfarin is not recommended during pregnancy. A woman who becomes pregnant or plans to become pregnant while undergoing warfarin therapy should notify her healthcare provider immediately.
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Preparation

  • It is important to tell all your healthcare providers that you are taking warfarin. If you are having surgery, dental work, or other medical procedures, you may need to stop taking warfarin.
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Interactions

  • Patients who take warfarin should consult with their healthcare provider before taking any new medication, including over-the-counter (nonprescription) drugs, herbal medicines, vitamins or any other products. Many medications can alter the effectiveness of warfarin, resulting in an INR that is either too high or too low. Some of the most common over-the-counter pain relievers, such as…
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